Over 1 year post op - Unhappy about results. Are they less than satisfactory? (photos)

Dear khock513,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. I’m sorry you are not satisfied with your result. However, it does appear that you are a good candidate for a revision. This would involve re-undermining the skin and trimming excess to provide a flatter and tighter contour. You would also benefit from revision liposuction of your flanks in order to smooth the contour, as well as to help accentuate your hips. Good luck.

You did not have vertical tightening with your tuck, but did get nice results. You could consider minimally invasive skin tightening like Renuvion or Thermitight to help improve the rest. Please discuss this with your surgeon.

Hi, khock513! Thank you for your question and photos.
Abdominal skin laxity occurs in two vectors: horizontal and vertical. In classical tummy-tuck, skin is removed in a horizontal fashion and sutured. In some patients there is also vertical skin excess. This skin is either removed with a vertical excision added to a horizontal excision (Fleur de Lis Operation) or this skin is left in place in those who don't want vertical scar.
This vertical crease may happen in patients where the upper part of excision is wider than the lower part, and the skin is puckered while suturing.
There is two options to solve your problem:First is to complete the tummy tuck with a vertical skin excision. Second is to extend your current scar to both sides and re-adapt the skin by pulling sidewards.
I would recommend the first one if additional scars are ok for you. This will further narrow your waist and will give a better result.

You need to revision the vertical tummy tuck and the depressive vertical scar line should be treated surgicallydr.hakan demir Antalya

it's difficult to judge your results without seeing post operative photos. At one year post op these are your final results. It appears you may be able to improve your results either with a revision or further liposuction. I encourage you to meet with your surgeon or another board certified plastic surgeon near you to learn more.

To make an assessment on the outcome of a procedure we add at your minimum need to see quality before and after pictures.
If you don’t have proper before and after pictures then ask your surgeon to forward the ones he or she took.
Each surgeon has grown way of designing Asian. Overall your results look typical or slightly above average.
The hallmarks have a quality tummy tuck are usually a natural appearing belly button and central abdominal With a very low sad scar that follows an atomic contours naturally. The scars should be even on both sides and the final shape of the torso should be attractive balanced and appropriate from all angles including from behind.Most plastic surgeons one that turned patients on their side or face down during a tummy tuck. this makes shaping the torso in the waist and love handles difficult and results are generally not as good as when Liposuction is done as a solo procedure.
There are also inherent safety reasons plastic surgeons may be apprehensive to do aggressive liposuction in conjunction with a tummy tuck.
Having both Liposuction and a tummy tuck is in fact having two procedures done at the same time.
Patient considering having multiple procedures should vet providers adequately in regards to skill and experience for both procedures.
I typically recommend patients ask providers to show their entire collection before and after pictures during in person consultations.
An experience provider should have no difficulty showing you at least 50 sets of before and after pictures during a consultation.
If the surgeon recommends liposuction then you should specifically ask to see lots of before and after pictures of their liposuction results.
If you’re having a tummy tuck then you should likewise ask to see as many before and after pictures as possible especially of previous patients who had similar body characteristics to your owner.
Do your results look similar to the before and after pictures you were shown during the consultation?
Did you have multiple in person consultations preparing results among different surgeons choosing the best one?
Getting back to your outcome.
I’m guessing that your plastic surgeon wanted to give you a very low set scar and in doing so was unable to remove all the skin of your lower abdomen including the incision around your belly button.
When that’s the case a small vertical scar is created between the new belly button position and the primary incision. This helps at least in part explain the vertical fold or line of your lower abdomen. It’s pretty common for plastic surgeons to do aggressive liposuction in a straight line along the midline above the belly button up to the rib cage to mimic showing muscle definition of the midline of the abdomen. This anatomic structure is called the linea alba. I would say most plastic surgeons try to emphasize and contour a vertical line from the belly button to the sternum. On young attractive bodybuilding type bodies usually there is a visible midline structure from the belly button to the sternum. That usually does not continue below the belly button. It’s possible your plastic surgeon continued liposuction in that same vertical line above and below your belly button. What does your surgeon have to say about the outcome?
Personally my preference on designing a tummy tuck scar is to make the incision slightly convex over the mons pubis then follow in the groin crease. This creates a full-wing type appearance. Others like in your case maintain a concave incision through the mons pubis. Personally I believe the natural curvature of the mons pubis is the other way around. (like the top of the clock from the 10 o’clock to 2 o’clock position).
Most plastic surgeons stay consistent with their tummy tuck incision designs and this should’ve been discussed and reviewed during the consultation when you had a chance at reviewing before and after pictures.
A tummy tuck is a fairly permanent and irreversible operation.
Once created it’s difficult to make significant improvements through revisions.
The time to be critical about results is during the vetting process when you are comparing the results of various plastic surgeons in the process of choosing the best provider.
My best guess is that your result is fairly typical for your provider.
Delivering consistent quality liposuction results is more difficult than most people believe.
Most plastic surgeons are not particularly good at Liposuction.
Most plastic surgeons however claim to be at least competent if not good to excellent at doing liposuction.
In reality delivering consistent quality liposuction results that are predictable based on reviewing before and after pictures of previous patients with similar body characteristics who had quality outcomes is actually quite rare.
Far too many plastic surgeons believe that Liposuction is a simplistic procedure with a low learning curve. They go through the motions of removing fat because it’s included and they’re charging for it but do not really put much emphasis in that part of the procedure since the tummy tuck is what they’re there for.
Liposuction results has more variation in outcome based on who does the procedure than any other plastic surgery operation I’ve ever seen.
There are plenty of board-certified plastic surgeons with overall good reputations who have years of experience who cannot deliver quality liposuction results on a regular basis.
That is not to say there are not lots of plastic surgeons who are really good at liposuction.
It is simply a procedure who is outcome varies greatly based on who does the operation.
The skill, experience and especially attitude towards liposuction varies greatly from surgeon to surgeon.
A fair number of plastic surgeons simply don’t like doing liposuction.
I suggest you follow up with your provider and discuss your concerns with him or her. While there you should also ask to get all copies of your before and after pictures so you can use those in the future if you want to get an assessment of your outcome.
In order to make an assessment on the results of a procedure we absolutely have to know what you look like before surgery.
Sometimes people who are unhappy with tummy tuck results should spend more time looking at their before pictures.
It is a very big operation and it will inevitably leave some small areas that come out a little different than anticipated.
It is not an operation that should be redone or revised unless absolutely necessary unless there are obvious flaws.
It’s not possible to give you a good assessment of why you have the fold or skin line of your lower abdomen.
Part of it is for sure related to closing the incision around your belly button in order to set the scar low.
Had to design been reversed with a convex approach over the mons pubis it may have been able to incorporate that part of the lower abdominal skin as part of the procedure. it’s easy to play Monday morning quarterback. Overall your outcome looks at least average to above average from what I see being posted on this website.
The incision is even and set very low. Your belly button looks better than most. Overall I would say it looks like very competent work.
It’s simply difficult to address the vertical line of your lower abdomen without an examination or having been present during surgery
Best,
Mats Hagstrom MD